Daniel T. Kim, Albany Medical College

I sit on an ethics review committee at the Albany Med Health System in New York state, where doctors and nurses frequently bring us fraught questions.

Consider a typical case: A 6-month-old child has suffered a severe brain injury following cardiac arrest. A tracheostomy, ventilator and feeding tube are the only treatments keeping him alive. These intensive treatments might prolong the child’s life, but he is unlikely to survive. However, the mother – citing her faith in a miracle – wants to keep the child on life support. The clinical team is distressed – they feel they’re only prolonging the child’s dying process.

Often the question the medical team struggles with is this: Are we obligated to continue life-supporting treatments?

Bioethics, a modern academic field that helps resolve such fraught dilemmas, evolved in its early decades through debates over several landmark cases in the 1970s to the 1990s. The early cases helped establish the right of patients and their families to refuse treatments.

But some of the most ethically challenging cases, in both pediatric and adult medicine, now present the opposite dilemma: Doctors want to stop aggressive treatments, but families insist on continuing them. This situation can often lead to moral distress for doctors – especially at a time when trust in providers is falling.

Consequences of lack of trust

For the family, withdrawing or withholding life-sustaining treatments from a dying loved one, even if doctors advise that the treatment is unlikely to succeed or benefit the patient, can be overwhelming and painful. Studies show that their stress can be at the same level as people who have just survived house fires or similar catastrophes.

While making such high-stakes decisions, families need to be able to trust their doctor’s information; they need to be able to believe that their recommendations come from genuine empathy to serve only the patient’s interests. This is why prominent bioethicists have long emphasized trustworthiness as a central virtue of good clinicians.

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However, the public’s trust in medical leaders has been on a precipitous decline in recent decades. Historical polling data and surveys show that trust in physicians is lower in the U.S. than in most industrialized countries. A recent survey from Sanofi, a pharmaceutical company, found that mistrust of the medical system is even worse among low-income and minority Americans, who experience discrimination and persistent barriers to care. The COVID-19 pandemic further accelerated the public’s lack of trust.

In the clinic, mistrust can create an untenable situation. Families can feel isolated, lacking support or expertise they can trust. For clinicians, the situation can lead to burnout, affecting quality and access to care as well as health care costs. According to the National Academy of Medicine, “The opportunity to attend to and ease suffering is the reason why many clinicians enter the healing professions.” When doctors see their patients suffer for avoidable reasons, such as mistrust, they often suffer as well.

At a time of low trust, families can be especially reluctant to take advice to end aggressive treatment, which makes the situation worse for everyone.

Ethics of the dilemma

Physicians are not ethically obligated to provide treatments that are of no benefit to the patient, or may even be harmful, even if the family requests them. But it can often be very difficult to say definitively what treatments are beneficial or harmful, as each of those can be characterized differently based on the goals of treatment. In other words, many critical decisions depend on judgment calls.

Consider again the typical case of the 6-month-old child mentioned above who had suffered severe brain injury and was not expected to survive. The clinicians told the ethics review committee that even if the child were to miraculously survive, he would never be able to communicate or reach any “normal” milestones. The child’s mother, however, insisted on keeping him alive. So, the committee had to recommend continuing life support to respect the parent’s right to decide.

Physicians inform, recommend and engage in shared decision-making with families to help clarify their values and preferences. But if there’s mistrust, the process can quickly break down, resulting in misunderstandings and conflicts about the patient’s best interests and making a difficult situation more distressing. https://www.youtube.com/embed/MY4e4l-eAFk?wmode=transparent&start=0 Moral distress in health care.

Moral distress

When clinicians feel unable to provide what they believe to be the best care for patients, it can result in what bioethicists call “moral distress.” The term was coined in 1984 in nursing ethics to describe the experience of nurses who were forced to provide treatments that they felt were inappropriate. It is now widely invoked in health care.

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Numerous studies have shown that levels of moral distress among clinicians are high, with 58% of pediatric and neonatal intensive care clinicians in a study experiencing significant moral distress. While these studies have identified various sources of moral distress, having to provide aggressive life support despite feeling that it’s not in the patient’s interest is consistently among the most frequent and intense.

Watching a patient suffer feels like a dereliction of duty to many health care workers. But as long as they are appropriately respecting the patient’s right to decide – or a parent’s, in the case of a minor – they are not violating their professional duty, as my colleagues and I argued in a recent paper. Doctors sometimes express their distress as a feeling of guilt, of “having blood on their hands,” but, we argue, they are not guilty of any wrongdoing. In most cases, the distress shows that they’re not indifferent to what the decision may mean for the patient.

Clinicians, however, need more support. Persistent moral distresses that go unaddressed can lead to burnout, which may cause clinicians to leave their practice. In a large American Medical Association survey, 35.7% of physicians in 2022-23 expressed an intent to leave their practice within two years.

But with the right support, we also argued, feelings of moral distress can be an opportunity to reflect on what they can control in the circumstance. It can also be a time to find ways to improve the care doctors provide, including communication and building trust. Institutions can help by strengthening ethics consultation services and providing training and support for managing complex cases.

Difficult and distressing decisions, such as the case of the 6-month-old child, are ubiquitous in health care. Patients, their families and clinicians need to be able to trust each other to sustain high-quality care.

Daniel T. Kim, Assistant Professor of Bioethics, Albany Medical College

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Betina Cutaia Wilkinson, Wake Forest University

Back in 2012, quarterback Colin Kaepernick was one of the NFL’s most popular stars. He led the San Francisco 49ers to the Super Bowl and was just a few plays away from winning the title and lifting the Lombardi Trophy.

But America’s focus on Kaepernick’s athletic success waned in 2016. That’s when he began to kneel before games during the playing of “The Star-Spangled Banner” to protest the deaths of young Black men at the hands of white police officers.

They included Alton Sterling and Philando Castile, two unarmed Black men killed by police in the summer of 2016.

“To me, this is bigger than football, and it would be selfish on my part to look the other way,” Kaepernick said in The Guardian newspaper. “There are bodies in the street and people getting paid leave and getting away with murder.”

Kaepernick’s activism, coinciding with the reemergence of the Black Lives Matter movement, received varied responses.

Some NFL players, like Kaepernick’s then-teammate Eric Reid, imitated Kaepernick’s actions, generating a wave of anti-racist activism – not just in football but in other sports, too, like women’s basketball. Others, including several NFL executives, responded with vitriol and hate.

A recent study I conducted with colleagues Lisa Kiang and Elizabeth Seagroves examines American attitudes toward sports activism, providing insight into the stark responses to Kaepernick’s advocacy and those of other athletes.

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Making sense of the varied responses

We surveyed 207 college students and 33 residents in Winston-Salem, North Carolina, where I teach, to examine their views on racial justice activism among professional athletes.

We found there were three general perspectives.

One group supported the sports activism and tied it to changing the status quo. People in this group back athletes’ ability to serve as activists and role models, and they hope the protests generate meaningful sociopolitical change.

“I thought it was very necessary and good,” said one participant in the study, referring to athletes’ activism. “I think that if they can use their platform for something good, they should.”

When we asked about Kaepernick’s activism in 2016, these participants lauded him for his courage.

They felt Kaepernick’s protests, along with the Black Lives Matter movement, helped raise awareness of racial injustices in the United States.

Participants reject racial justice advocacy

Other participants in our study expressed support for athletes’ right to protest, but they rejected their racial justice advocacy.

They said athletes have the freedom to say what they think. And they tied the protests to the United States’ commitment to freedom of speech. But they disapproved of kneeling during the playing of the national anthem, labeling it as disrespectful.

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“I think most of it is good. If you have a platform, you should use it,” one participant told us. “However, when misinformation is spread, it becomes bad.”

Several participants felt the conflation of the national anthem with protesting racial injustices was misleading and wrong, and this participant considered Kaepernick’s protest “misinformation.”

Kaepernick’s activism elicited similarly mixed feelings at the time. A majority of the public viewed Kaepernick’s refusal to stand as unpatriotic. Most, however, also supported his right to free speech.

In May 2018, NFL Commissioner Roger Goodell barred athletes from protesting on the sidelines during the national anthem, but he gave them the option to remain in the locker room during the playing of “The Star-Spangled Banner” if they preferred. The move came after players had protested racial inequality and police brutality for two seasons.

“We want people to be respectful of the national anthem,” Goodell said, according to ESPN. “We want people to stand – that’s all personnel – and make sure they treat this moment in a respectful fashion. That’s something we think we owe. But we were also very sensitive to give players choices.”

In June 2020, in the wake of George Floyd’s death and years into Kaepernick’s activism, Goodell apologized to players and reversed the policy, saying, “We were wrong for not listening to NFL players earlier.”

But team protests varied throughout the league.

Some teams such as the Green Bay Packers and Jacksonville Jaguars, at least on one occasion, remained in their locker rooms during the playing of “The Star-Spangled Banner.”

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Some teams acted uniformly with the exception of one or two players. Dallas Cowboys player Dontari Poe was the only person on his team to kneel during the playing of the national anthem.

The fact that not all players protested, and that teams had distinct approaches to protesting, is not surprising given the public’s varied responses to athlete activism.

Complete disapproval

A third group of participants in our study disapproved of sports activism entirely. And these participants often accompanied their criticism by saying that athletes strayed from their role as entertainers.

“I don’t think it’s good because it’s giving people a reason not to like a professional athlete when their job is to play a sport. They are not politicians and haven’t been able to prove they can make a change,” said one participant.

For example, when responding to WNBA player Skylar Diggins-Smith’s call for the imprisonment of the police officers in Louisville, Kentucky, involved in the 2020 shooting death of Breonna Taylor during a nighttime apartment raid, one participant said: “It’s not for the average citizen to call for police officers to be investigated. It’s just not OK for a professional athlete to push their agenda like that.”

Our study, much like other studies, found that people who are white, older and politically conservative are more opposed to racial justice activism in sports than their counterparts.

What does this mean?

As seen in our study, U.S. views toward sports protests are tied to the role people believe athletes should play in society.

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For some, athletes can and should be role models; that includes by raising awareness of racial injustices. For others, athletes should only express their perspectives under certain conditions.

And yet other Americans believe athletes are performers whose only role should be to entertain.

Still, there’s no doubt Kaepernick’s activism changed the playing field, even if his NFL career suffered. After the 2016 season, he was never picked up by another team.

Kaepernick’s activism inspired people to attend protests and donate to political causes.

The NAACP has asked college athletes to avoid attending schools that are dismantling their diversity, equity and inclusion, or DEI, initiatives.

Coach Steve Kerr and All- Star Steph Curry of the Golden State Warriors regularly voice their political views and draw attention to injustices.

Several sports associations – the NFL, NBA, WNBA and NWSL – have implemented social justice initiatives and councils that strive to mobilize voters and educate the electorate on political issues.

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Colin Kaepernick’s activism may have ended his Super Bowl dreams, but his legacy extends far beyond the game of football.

Betina Cutaia Wilkinson, Associate Professor & Associate Chair of Political Science, Wake Forest University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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As of early February 2025, Kroger has announced a series of food recalls affecting customers across at least 15 states, as well as several subsidiary stores nationwide. The recalls, initiated due to safety concerns, include a variety of products that consumers should be aware of.

Twelve Hummus Tubs from King Harvest

Kroger subsidiary stores Fred Meyer and QFC, located in Alaska, Idaho, Oregon, and Washington, have recalled the following King Harvest hummus tubs, each weighing 10 oz:

• King Harvest Lemon Hummus
• King Harvest Classic Hummus
• King Harvest Roasted Garlic Hummus
• King Harvest Toasted Onion Hummus
• King Harvest Chipotle Hummus
• King Harvest Spinach Hummus
• King Harvest Black Olive Hummus
• King Harvest Sesame Hummus
• King Harvest Jalapeño Hummus
• King Harvest Balsamic Hummus
• King Harvest Sun Dried Tomato Hummus
• King Harvest Roasted Pepper Hummus

These products were recalled on February 5, 2025, due to a defect in their plastic tubs that may lead to the presence of plastic foreign objects within the containers. Kroger has advised customers, “Customers who purchased any of the item(s) below should not eat the product.” It remains unclear whether this recall is connected to a previous incident from September 2024 involving similar concerns.

DJs Boudain Products in Texas and Louisiana

Kroger stores in Texas and Louisiana have also issued a recall for the following DJs Boudain products:

• DJs Boudain Hot Jalapeño Boudain, 12 oz
• DJs Boudain Boudain Sausage, 24 oz
• DJs Boudain Boudain Sausage, 16 oz

These items were recalled on February 1, 2025, due to potential contamination with pieces of a pen. This recall is part of a broader action directed by the U.S. Department of Agriculture (USDA), which called for around 17,720 pounds of boudain sausage link products to be removed from stores across Louisiana, Mississippi, and Texas.

Gerber Products for Teething Children

In addition, two Gerber products intended for teething children were recalled from Kroger stores across multiple states, including Ohio, Virginia, Michigan, Indiana, Illinois, Missouri, Kentucky, Tennessee, Alabama, North Carolina, West Virginia, Texas, and Louisiana. The affected products are:

• Gerber Soothe N Chew Teething Sticks Banana, 3.2 oz
• Gerber Soothe N Chew Teething Sticks Strawberry Apple, 3.2 oz

These products were removed from shelves due to potential choking hazards. Kroger has assured customers that those who purchased these items can return them for a full refund. This recall is part of a nationwide action announced by the Food and Drug Administration (FDA). Gerber has expressed regret over the situation, stating, “The recall was initiated after receiving consumer complaints of choking incidents. To date, one emergency room visit has been reported to the firm…We sincerely apologize for any concern or inconvenience this action represents to parents, caregivers, and retail customers.”

Conclusion

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Customers who have purchased any of the recalled products are urged to refrain from consuming them and to return the items for a refund. It is always advisable to stay informed about food recalls to ensure the safety of you and your family. For more updates on recalls and food safety, keep an eye on announcements from Kroger and the relevant health authorities. Stay safe!

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Read the article in Newsweek: https://www.newsweek.com/kroger-food-recalls-issued-15-states-full-list-products-impacted-2027160

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